小承气汤加减对消化道肿瘤术后肠梗阻的疗效

Therapeutic effect of Xiaochengqi decoction in the treatment of intestinal obstruction in postoperative patients with gastrointestinal tumors

目的研究小承气汤加减治疗消化道肿瘤术后肠梗阻的疗效。方法选择安徽医科大学第一附属医院2020年1月-2023年6月收治的消化道肿瘤术后肠梗阻患者临床资料为研究对象,根据治疗方法的不同按照2:1分别纳入60例行西医常规治疗的患者作为西医常规组和30例联合小承气汤加减口服治疗的患者作为小承气汤组,观察至患者出院。比较2组患者治疗临床疗效、症状改善时间及恢复情况、治疗期间不良反应发生情况,比较2组治疗前后疼痛及生活能力评分、实验室指标。结果小承气汤组总有效率高于西医常规组(P<0.05)。小承气汤组腹痛腹胀缓解时间、恶心呕吐缓解时间、气液平面消失时间、肠鸣音恢复时间、首次排气时间、首次排便时间、住院时间短于西医常规组,住院总费用低于西医常规组(P<0.05)。2组疼痛评分及外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)水平治疗后与治疗前比较,降低,小承气汤组低于西医常规组(P<0.05);2组生活能力评分及血清前白蛋白(PA)水平治疗后与治疗前比较升高,小承气汤组高于西医常规组(P<0.05)。2组患者治疗期间均未发生明显不良反应。结论相对于西医常规治疗,联合中药小承气汤加减口服治疗消化道肿瘤术后肠梗阻,可有效改善患者的临床症状及实验室指标水平,缩短病程的同时,能够提高患者生活质量和生活水平,安全有效。

Objective To study the curative effect of modified Xiaochengqi decoction in the treatment of intestinal obstruction in postoperative patients with gastrointestinal tumors.Methods The clinical data of postoperative patients with gastrointestinal tumors admitted to the First Afiliated Hospital of Anhui Medical University from January 2020 to June 2023 were retrospectively collected as the study subjects.According to their different treatment methods and in a 2:1 ratio,60 patients receiving a conventional western medicine treatment were included as the conventional western medicine group and 30 patients receiving a combined oral treatment with modified Xiaochengqi decoction were included as the Xiaochengqi decoction group.All of them were treated for 5 days and observed until they were discharged.The clinical efficacy,symptom improvement time and recovery after treatment,the occurrence of adverse reactions during treatment were compared between the two groups,and the scores of pain and living ability and laboratory indicators were compared between the two groups before and after treatment.Results The total effective rate of the Xiaochengqi decoction group was higher than that of the conventional western medicine group(P<0.05).The relief time of abdominal pain and distension,nausea and vomiting,disappearance time of gas-liquid level,recovery time of bowel sound,first exhaust time,first defecation time and hospitalization time were shorter in the Xiaochengqi decoction group than those in the conventional western medicine group,and the total hospitalization cost was lower than that in the conventional western medicine group(P<0.05).The scores of pain,the levels of neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in peripheral blood were lower in the two groups after treatment than before treatment,and the Xiaochengqi decoction group was lower than the conventional western medicine group(P<0.05).The life ability scores and the level of serum prealbumin(PA)were higher in the two groups after treatment than before treatment,and the Xiaochengqi decoction group was higher than the conventional western medicine group(P<0.05).No significant adverse reactions occurred in both groups during treatment.Conclusion In the treatment of intestinal obstruction in postoperative patients with gastrointestinal tumors,compared with a solo conventional western medicine treatment,a combined oral treatment with modified Xiaochengqi decoction can effectively improve their clinical symptoms and laboratory indicators,shorten the course of the disease,and improve the quality of life and living standards of patients,which is safe and effective.